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Table 4 Mental health (MH) service use

From: Implementation of three innovative interventions in a psychiatric emergency department aimed at improving service use: a mixed-method study

 

Brief intervention team

(n = 44)

Crisis center team

(n = 37)

Total

(n = 81)

Before a

After b

Before a

After b

Before a

After b

n/mean

%/SD.

n/mean

%/SD.

n/mean

%/SD.

n/mean

%/SD.

n/mean

%/SD.

n/mean

%/SD.

Has a family doctor

31/41

75.61

N/A

N/A

31/34

91.18

N/A

N/A

62/75

82.67

N/A

N/A

Use of services

30

68.18

201

45.45*

28

75.68

261

70.27

58

71.60

461

56.79*

Primary care

(n = 30)

 

(n = 20)

 

(n = 28)

 

(n = 26)

 

(n = 58)

 

(n = 46)

 

General practitioners

20

66.67

51

25.00**

20

71.43

141

53.85

401

68.97

191

41.30**

Local community health service centers

12

40.00

91

45.00

10

35.71

71

26.92

221

37.93

161

34.78

Psychologists (private practice)

12

40.00

81

40.00

12

42.86

81

30.77

241

41.38

161

34.78

Community organizations

5

16.67

22

10.00

12

42.86

71

26.92

171

29.31

91

19.57

Specialized services

Outpatient psychiatrists

5/30

16.67

0/202

0.00

19/28

67.86

14/261

53.85

24/58

41.38

14/451

31.11

Outpatient hospital services

2

4.55

22

4.55

24

64.86

251

67.57

26

32.10

271

33.33

Number of different types of outpatient hospital services (mean, SD.) c

1.00

0.00

1.003

0.00

1.38

0.65

1.283

0.61

1.35

0.63

1.263

0.59

Frequency of overall outpatient hospital services used (mean, SD.)

1.00

0.00

2.003

0.00

6.79

7.20

4.803

3.28***

6.35

7.09

4.593

3.24***

Duration of overall outpatient hospital services used in weeks (mean, SD.)

14.64

14.45

5.143

1.62

31.70

16.30

15.673

7.59

30.38

16.56

14.893

7.82

Emergency department (ED) visits

14

31.82

61

16.22*

20

45.45

141

37.84

34

41.98

201

24.69*

Number of ED visits (mean, SD.) d

1.43

0.85

1.833

0.75

2.20

1.58

1.793

0.89

1.88

1.37

1.803

0.83

Hospitalization

5

11.36

42

10.81

23

52.27

111

29.73**

28

34.57

151

18.52*

Number of hospitalizations (mean, SD.)

1.20

0.45

1.253

0.50

1.61

0.89

1.093

0.30

1.54

0.84

1.133

0.35

Adequacy of MH services (mean SD.) e

2.05

0.82

2.703

0.47**

2.42

0.73

2.623

0.64

2.22

0.80

2.653

0.57**

Reasons why needs were not met (Denominator: n)

(n = 28)

   

(n = 16)

   

(n = 44)

   

Preferred to manage on his/her own

2

7.14

N/A

N/A

6

37.50

N/A

N/A

8

18.18

N/A

N/A

Reasons related to healthcare system f

24

85.71

N/A

N/A

15

93.75

N/A

N/A

39

88.64

N/A

N/A

Reasons related to the person (individual reasons) g

14

50

N/A

N/A

12

75

N/A

N/A

26

59.09

N/A

N/A

  1. aMeasured at 12 months before ED visit with referral to an intervention
  2. bMeasured at 6 months after discharge from the intervention
  3. cTypes of outpatient services used including brief evaluation and intervention programs, outpatient clinics (specialized MD), day hospitals, and other types of specialized outpatient MH services (e.g. electrophysiology, nutrition)
  4. dThis account of the 12-month ED visits did not include the ED visit leading to the interventions
  5. eMeasured on a five-point Likert scale (1: the services are not adequate to 5: the services are entirely adequate)
  6. fHealthcare system reasons included: help isn’t readily available, language problems, don’t have the financial means, insurance doesn’t cover the costs, don’t have confidence in the services, dissatisfied with the quality of services
  7. gIndividual reasons included: don’t know how or where to obtain the type of help appropriate to my problem, don’t find time to look after it, employment or occupation prevented me from seeking help, afraid of what others will think of me, prefer to count on my family or friends to help me
  8. 1,2,3Comparison analyses were conducted to assess statistical differences between groups (before and after) by teams (brief intervention team, crisis center team and total): 1 Chi-square test or 2 Fisher’s exact test were used for categorical variables and 3 t-tests for continuous variables. Significance indicated by: p < 0.001***; p < 0.01**; p < 0.05*
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BMC Health Services Research

ISSN: 1472-6963

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